Globe rupture as a complication of intravitreal injection of triamcinolone

Ung, Tsiang; Williams, Connie; Canning, C R

doi:10.1038/sj.eye.6702599

Cited by 11 publications

(4 citation statements)

References 7 publications

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“…Intravitreal injections can lead to scleral perforation4 in thin sclera situations (sclerotomy site, repetitive subtenon corticosteroid, rheumatoid arthritis, or high myopia). The scleral entry site made by 30 gauge needle measures 0.31 mm and is sealed by vitreous.…”

Section: Discussionmentioning

confidence: 99%

Visual loss from hyphema following intravitreal bevacizumab

Mansour

2010

Case Reports

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Intravitreal injections are the most common ocular procedures in an ophthalmic practice. Despite their safety profiles, complications can happen such as visually threatening intraocular bleeding. We present a case of a 32-year-old woman with idiopathic retinal vasculitis (Eales' disease), rubeosis iridis, and visual loss in the left eye from cystoid macular oedema. The patient had prior vitrectomy and multiple subtenon injections of corticosteroids. She underwent injection of intravitreal bevacizumab. The patient rubbed her eyes and developed subtotal hyphema. She also subsequently developed a panic attack. The bleeding spontaneously resolved over several hours. In eyes needing intraocular injections, caution needs to be taken in patients with rubeosis iridis who have had prior vitrectomy and subtenon injections of corticosteroids, and they need to be instructed to avoid ocular rubbing.

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Section: Discussionmentioning

confidence: 99%

Visual loss from hyphema following intravitreal bevacizumab

Mansour

2010

Case Reports

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“…Intravitreal appliziertes TA bietet mehrere Vorteile bei der Behandlung von ödematösen oder neovaskulären Netzhauterkrankungen [14]. Eine Bulbusruptur infolge intravitrealer TA-Applikation ist bislang nur in einer Arbeit beschrieben worden [22].…”

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“…10% des GK-Volumens). Eine Bulbusruptur ist bereits bei einem wesentlich kleineren Injektionsvolumen von 0,1 ml Triamcinolon bei einem Patienten ohne weitere Risikofaktoren beschrieben worden [22]. Intravitreal applizierte Medikamente können zu einer akuten Drucksteigerung führen mit einer Kaskade von Komplikationen, wie z.…”

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Bulbusexplosion durch intravitreale Injektion

Viestenz

Küchle²,

Behrens–Baumann³

2008

Klin Monatsbl Augenheilkd

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An 83-year old female was given an intravitreal injection of 0.4 ml of triamcinolone acetonide (TA) by her local ophthalmologist for age-related maculopathy with a large choroidal neovascularisation in the left eye. During the injection, globe explosion occurred with nasal limbal rupture and extrusion of intraocular contents. Emergency primary wound repair was performed at the Eye Surgery Centre Erlangen-Mitte. During surgery, a 9 mm limbal rupture with prolapse of half of the iris and subconjunctival extrusion of the complete natural lens was discovered. After lens removal, anterior vitrectomy and iris repositioning, the wound was closed and the eye left aphakic. The further postoperative course was unremarkable and the patient retained her preoperative visual acuity of counting fingers. In this case, several factors may have contributed to the dramatic events: relative nanophthalmus (preoperative refraction + 5.0dpt), scleral weakness secondary to chemotherapy for leukemia, older age, and a relatively large volume of injected TA. The intravitreal injection of drugs may cause serious complications. Paracentesis or limited pars plana vitrectomy should be considered prior to intravitreal injection in high-risk cases to prevent such disastrous complications.

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“…5 However, the complications of using iVTA are numerous; intraocular pressure rise and cataract are common occurrences. In a retrospective analysis in Southampton, the ocular morbidity is high 6 as well as the case report of ocular perforation 7 and inadvertent administration of intralenticular injection. 8 One would probably consider in the face of the lack of evidence that is unacceptably high.…”

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confidence: 99%